Projects on Organ Transplantation in the Research Group Schicktanz



Publication List of the Research Group

Publication List (PDF)


2018 – 2021: Survey: "International Student Survey on the Knowledge and Attitudes towards Donation and Transplantation of Organs/Body Parts (ISSATO)"

Carried out by:
Dr. Sabine Wöhlke sabine.woehlke(at)gwdg.de

Contact:
Prof. Dr. Silke Schicktanz sschick(at)gwdg.de

The aim of the planned survey is to analyse the knowledge and the attitudes of students across different European countries about the regulations’ of post-mortem organ donation.
We want to shed light on key ethical and social challenges that organ transplantation raises with a focus on laypersons’ attitudes in different European countries. This study will strengthen the public discourse and give ethical recommendations for dealing with this technology.

Project website


2018 – 2020: Research Project: “'I Would Prefer Not To'. Organ Donation Between Unease and Criticism. A Sociological and Ethical Analysis" (Follow-Up)

Carried out by:
Dr. Solveig Lena Hansen shansen(at)gwdg.de

Contact:
Prof. Dr. Silke Schicktanz schick(at)gwdg.de 
Funding: German Research Foundation (DFG)
Duration: 2018–2020

Project website

The project is a sequel to the project ‘I would prefer not to.’ Organ donation between unease and criticism. In the first stage, the motives of skeptics of organ donation as well as of the undecided were examined along with the posters of German organ donation campaigns of the past 20 years. The main results highlight four types of criticism which are not directly linked to the recent events in the transplantation system. However, they also highlight six different moral messages in the posters that are historically associated with important events and disruptions in the transplantation system. These results indicate that specific positions and aspects are excluded both in the public discourse and in health policy.

In the second stage, strategies of the public discourse and of health communication which systematically exclude positions are to be reconstructed as well as their consequences for the critics. Moreover, these strategies of exclusion should be reflected normatively for the development of ideas concerning concrete discursive inclusion of positions that are currently being declassified as "irrational".

The sociological project will, from a theoretical perspective, question how the arguments of these "irrational" positions can be understood as well-founded arguments. In addition, the project will analyse the strategies that exclude these positions in daily life as well as in health policy and the academic discourse.
Particularly, the one-sidedness of the analysed campaigns illustrates the conflict of interest of the Transplantation Act. On the one hand, institutions of health policy have to inform neutrally about the topic in order to allow a self-determined decision. On the other hand, organ donation should be promoted to increase the number of transplants. Accordingly, the bioethical subproject questions how a normative concept of public health communication can be designed to achieve a reflective balance between individual self-determination and the collective interest in organ transplants. Therefore, the analysis aims at critically addressing the question of what comprises 'good' information in such a sensitive field. Moreover, the personal attitudes and moral convictions for and against organ transplantation are to be better understood.

By developing socio-theoretical and normative approaches, both subprojects aim at a critical analysis of the high symbolic value of organ transplantation for the self-conception of modern high-tech medicine.

Hansen, Solveig Lena / Schicktanz, Silke (Hg.) (2020): Ethical Challenges of Organ Transplantation. Current Debates and International Perspectives. Bielefeld: transcript. Link

Hansen, Solveig Lena / Schicktanz, Silke (2020): A Conceptual Map of Ethical Issues in Organ Transplantation. In: Hansen, Solveig Lena / Schicktanz, Silke (Hg.) (2020): Ethical Challenges of Organ Transplantation. Current Debates and International Perspectives. Bielefeld: transcript. Link

Hansen, Solveig Lena / Beier, Katharina (2020): Just a phrase? Normative Implications of Trust in Discourses on Organ and Tissue Donation. In: Hansen, Solveig Lena / Schicktanz, Silke (Hg.) (2020): Ethical Challenges of Organ Transplantation. Current Debates and International Perspectives. Bielefeld: transcript (im Erscheinen).

Adloff, Frank / Hilbrich, Iris (2019): Der Organspendediskurs in Deutschland und die diskursive Exklusion von Kritik. In: S. M. Probst (Hg.): Hirntod und Organspende aus interkultureller Sicht, Berlin: Hentrich und Hentrich, 102-116. Link

Schicktanz, Silke (2019): Anmerkungen zur Geschichte der Transplantationsmedizin und ihrer ethischen und kulturellen Relevanz. In: O. Ette, U. Wirth (Hg.): Kulturwissenschaftliche Konzepte der Transplantation. Berlin/Boston: De Gruyter, 123-146. Link

Böhrer, Annerose (2018): Entscheiden, Ankreuzen, Verfügen – Auf der Spur des Organspendeausweises. In: R. Hitzler et al. (Hg.): Herumschnüffeln, aufspüren, einfühlen. Ethnographie als ‚hemdsärmelige‘ und reflexive Praxis, Essen: Oldib-Verlag, 355-368.

Hansen, Solveig Lena / Schicktanz, Silke (2018): Bilder fürs Leben: Versteckte moralische Botschaften als Reaktion auf die Krise der Organspende. In: A. Esser et al. (Hg.): Die Krise der Organspende – Anspruch, Analyse und Kritik aktueller Aufklärungsbemühungen im Kontext der postmortalen Organspende in Deutschland. Berlin: Duncker & Humblot, 85-114. Link

Schaper, Manuel / Hansen, Solveig Lena / Schicktanz, Silke (2018): Überreden für die gute Sache? Techniken öffentlicher Gesundheitskommunikation und ihre ethischen Implikationen. In: Ethik in der Medizin, 31, 23-44. DOI:10.1007/s00481-018-0507-7

Conference: Eingriffe in den Körper: Zurückhaltung, Kritik oder Deliberation?, 19.-20.02.2020 in Hamburg
Here you can download the Flyer and the Poster (PDF).

Workshop: Engaging the Skeptics?! - Epistemic (In)justice, Public Participation, and Moral Expertise in Health Discourses, 4.-5.03.2019 in Göttingen
Here you can download the Flyer and the Poster (PDF).

Workshop: Und dann haben sie mich mundtot gemacht." - Narrative, Unsichtbarkeit und Exklusion in diskursiven Arenen, 20.10.2018 in Hamburg
Here you can download the Flyer (PDF).

Workshop: Multimodalität und angewandte Ethik, 16.05.2018 in Innsbruck
Here you can download the Flyer (PDF).

  • Hilbrich, Iris / Hansen, Solveig Lena (2020): Appelle – Ambivalenz – Abwehr: soziologische und ethische Perspektiven auf Organtransplantation in Deutschland, In: Eingriffe in den Körper: Zurückhaltung, Kritik oder Deliberation?, Universität Hamburg.
  • Hansen, Solveig Lena / Wöhlke, Sabine (2020): Imaginierte Beziehungen und die körperliche Verfügbarkeit in der Transplantationsmedizin, In: Ringvorlesung: Verwandtschaft neu denken, Centrum für Geschlechterforschung, Universität Göttingen.
  • Hansen, Solveig Lena (2019): Wie und warum erzählen Gesundheitskampagnen? In: Ringvorlesung: Erzählen, Seminar für Deutsche Philologie, Abteilung Komparatistik, Göttingen.
  • Hansen, Solveig Lena (2019): Ergebnisoffene Aufklärung zur Organspende – eine Bestandsaufnahme und ethische Reflexion. In: Jahrestagung der Deutschen Transplantationsgesellschaft, Hannover.
  • Hansen, Solveig Lena / Beier, Katharina (2019): Public Confidence or Public Acceptance? Reflecting the Role of Trust in Bodily Donations from an Ethical Perspective, In: Jahrestagung der Deutschen Transplantationsgesellschaft, Hannover.
  • Hansen, Solveig Lena / Beier, Katharina (2019): Trust in Organ and Tissue Donation: an Ethical Analysis (Posterpräsentation), In: Konferenz: Kollektivität im Gesundheitswesen: Ethische Theorien und Praxisfelder von Gruppen als Akteuren, Jahrestagung der Akademie für Ethik in der Medizin, Göttingen.
  • Schicktanz, Silke (2019): Epistemic (In)Justice, Counter Publics and Sceptics in Bioethical Conflicts. In: Engaging the Sceptics - Epistemic (In)justice, Public Participation, and Moral Expertise in Health Discourses, Workshop, Göttingen.
  • Schicktanz, Silke / Hansen, Solveig Lena (2019): To Donate or not to Donate: an Empirical: An Ethical Study of Moral Attitudes to  Organ Donation Posters, In: 5th ELPAT Congress, European Platform Ethical, Legal, and Psychological Aspects of Transplantation, Krakau (Polen). 
  • Hansen, Solveig Lena (2019): Organtransplantation in Deutschland: Eine bioethische Perspektive auf Konflikte, Kampagnen und Kritik, ZONTA Service Club Göttingen.
  • Hansen, Solveig Lena (2019): Distrust in Health Information? Ethical Reflection in Times of Digital Communication, In: Engaging with the Skeptics?! Epistemic (In)justice, Public Participation, and Moral Expertise in Health Discourses, Workshop, Universitätsmedizin Göttingen.
  • Hansen, Solveig Lena (2019): Kampagnen, Konflikte und Kritik: Empirisch-ethische Perspektiven auf Organtransplantation in Deutschland, In: Centre for Ethics and Law in the Life Sciences, Institutskolloquium, Universität Hannover.
  • Adloff, Frank / Hilbrich, Iris (2018): Ja? Nein? Vielleicht? Diskursive Exklusion von Kritik im Organspendediskurs in Deutschland, In: Hirntod und Entscheidung zu Organspende aus interkultureller / interreligiöser Sicht. Multiprofessionelle, interkulturelle Fachtagung, Klinikum Bielefeld (11/2018).
  • Adloff, Frank / Hilbrich, Iris (2018): Diskursive Ausschlüsse von Kritik im Organspendediskurs in Deutschland, In: ,,Und dann haben sie mich mundtot gemacht." Narrative, Unsicherheit und Exklusion in diskursiven Arenen, Workshop, Universität Hamburg (10/2018).
  • Hansen, Solveig Lena (2018): Leerstellen und Kontraste: Websites als diskursive Ressource für Deutungen der Transplantationsmedizin, In: Mulitmodalität und angewandte Ethik, Workshop, Universität Innsbruck am 16. Mai. 2018.
  • Hansen, Solveig Lena / Schicktanz, Silke (2018): Hauptsache, Sie informieren sich - Ethische Herausforderungen digitaler Gesundheitskommunikation am Beispiel der Organspende, In: Medizin 4.0: Ethik im digitalen Gesundheitswesen, Jahrestagung der Akademie für Ethik in der Medizin, Köln (09/2018).
  • Hansen, Solveig Lena (2018): Organstransplantation in Deutschland: Eine bioethische Perspektive auf Konflikte, Kampagnen und Kritik, In: Institutskolloquium Devision of Biochemistry, Universität Innsbruck (Österreich).
  • Hansen, Solveig Lena (2018): Mulitmodality as a New Methodology for Applied Ethics, In: Methods in Applied Ethics, Conference of the Department of Philosophy and Religious Studies, NTNU Trondheim, Norway (04/2018).

 

  • "Doktorandin der Soziologie forscht zum Thema Organspende", Interview mit Annerose Böhrer am 23. Januar 2020
  • "Dilemma Organspende - Einwände gegen die Widerspruchslösung" mit Solveig Lena Hansen, In: SWR am 02.12.2019
  • ,,Schweigen als Zustimmung. Widerspruchslösungen bei der Organspende" mit Solveig Lena Hansen, In: Deutschlandfunk am 01. September 2019 
  • "Schlagzeilen und Missverständnisse zur Organspende" mit Solveig Lena Hansen, In: Gerechte Gesundheit, November 2018
  • ,,Organtransplantation - Die Lebenden reparieren", In Ethics' Anatomy, Filmreihe der Universitätsmedizin Göttingen 11. Juni 2018
  • ,,Organe gesucht - was tun, wenn Niere, Leber und Herz knapp werden?", In: ,,Die Debatte", Wissenschaft im Dialog gGmbH, Berlin März 2018: Komplette Aufzeichnung

 


2014 – 2016: Research Project: "'I Would Prefer Not To'. Organ Donation Between Unease and Criticism. A Sociological and Ethical Analysis"

Carried out by:
Dr. Solveig Lena Hansen shansen(at)gwdg.de

Contact:
Prof. Dr. Silke Schicktanz sschick(at)gwdg.de 
Funding: German Research Foundation (DFG)
Duration: 2014–2016

The project explores how people deal with the public demand for being an organ donor in Germany, especially when they take a critical or skeptical position.

The sociological subproject (PI: Prof. Dr. Frank Adloff, University of Erlangen-Nuremberg) conducts interviews and focus groups with citizens addressing their uncertainties, disappointments, fears, and vulnerabilities towards post-mortem organ donation.

The bioethical subproject (PI: Prof. Dr. Silke Schicktanz, University Medical Center Göttingen) analyzes various German poster campaigns that were carried out in the last ten years. At first glance, they conceptualize organ donation predominantly as a free decision everyone should make for themselves. However, the analysis examines which implicit claims and commitments the campaigns put forward visually.

Moreover, drawing on the empirical data of the sociological subproject, the Göttingen project analyzes the moral perspective of laypeople, who are skeptic or at least uncertain towards organ donation, as well as their moral intuitions concerning those contemporary campaigns.

The project assumes that uncertainty and skepticism are legitimate intuitions. Based on these premises, ethical theorizing includes asking how far anthropological attitudes towards corporeality and mortality can be rationally communicated and publicly debated in a society characterized by liberalism and value pluralism.

The bioethical analysis of public moral encouragement and further development of socio-theoretical and normative approaches reflects the social significance of transplantation medicine and aims to develop ideas how to deal with ethical problems in public discourse.

Dinçel, Doğa (2019): Masterarbeit im Fach Kulturanthropologie/Europäische Ethnologie: Gender, Alter und Ethnizität in deutschen Organspendekampagnen - Eine multimodale und filmethnografische Analyse. [Der dazugehörige Dokumentarfilm "Organspendekampagnen in Deutschland: Zur Repräsentation von Gender, Alter & Ethnizität" ist aus Datenschutzgründen online nicht verfügbar.]

Pfaller, L / Hansen, SL / Adloff, F / Schicktanz, S (2018): 'Saying no to organ donation': an empirical typology of reluctance and rejection. Sociology of Health and Illness, DOI: 10.1111/1467-9566.12775

Adloff, F / Pfaller, L (2017): Critique in statu nascendi? The reluctance towards organ donation. Historical Social Research 42(3), DOI: 10.12759/hsr.42.2017.3.24-40

Schicktanz, Silke / Wöhlke, Sabine (2017): The Utterable and Unutterable. Anthropological Meaning of the Body in the Context of Organ Transplantation. Dilemata, 9, 23, 107-127. Link

Schicktanz, Silke / Wöhlke, Sabine (2017): Leben im Anderen. Vorstellungen zur Personalitätsübertragung zwischen kulturell Sagbarem und Unsagbarem. In: H. Knoblauch et al. (Hg.): Transmortalität und Organspende. Weinheim, 75-105. Link

Hansen, SL / Eisner, MI / Pfaller, L / Schicktanz, S (2017): "Are you in or are you out?!" Moral Appeals to the Public in Organ Donation Poster Campaigns - a Multimodal and Ethical Analysis. Health Communication, DOI:10.1080/10410236.2017.1331187

Schicktanz, S /  Pfaller, L / Hansen, SL / Boos, M (2017): Attitudes towards brain death and conceptions of the body in relation to willingness or reluctance to donate: results of a student survey before and after the German transplantation scandals and legal changes. Journal of Public Health, DOI: 10.1007/s10389-017-0786-3 

Schicktanz, S / Pfaller, L / Hansen, SL (2016): Einstellungen zur Organspende - kulturell tief verwurzelt. Deutsches Ärzteblatt 113, 37, A1586-1588. 

Conference July 7th -19th, 2016 in Erlangen

You can download the Flyer including the Program here (PDF)

International Workshop, October 7th, 2015

You can download the Program here (PDF)

You can download the Poster here (PDF)

  • Pfaller, Larissa / Hansen, Solveig Lena / Schicktanz, Silke (2017): Das "Nein" zur Organspende verstehen - eine Typologie kritischer Positionen, In: Jahrestagung der Deutschen Transplantationsgesellschaft, Bonn (10/2017).
  • Schaper, Manuel / Hansen, Solveig Lena / Schicktanz, Silke (2017): Ethische Dimensionen öffentlicher Gesundheitskommunikation zwischen Aufklären und Überzeugen, In: Jahrestagung der Akademie für Ethik in der Medizin, Hannover (09/2017).
  • Hansen, Solveig Lena / Schicktanz, Silke (2017): Multimodality as a Methodology for Analyzing Public Health Campaigns: the Example of Organ Transplantation in Germany, In: Third Bremen Conference on MultimodalityInstitut für transmediale Textualitätsforschung, Universität Bremen (09/2017).
  • Hansen, Solveig Lena / Pfaller, Larissa / Schicktanz, Silke (2017): Reaktionen auf deutsche Poster-Kampagnen: Eine empirisch-ethische Studie (Posterpräsentation), In: Jahrestagung Deutsche Transplantationsgesellschaft, Bonn.
  • Hansen, Solveig Lena / Böhrer, Annerose (2016): Organtransplantation in Deutschland. Ein Überblick über Kampagnen, ihre Wirkweisen und ethische Relevanz, In: IPPNW-Studierendentreffen, 12.11.2016, Hannover.
  • Hansen, Solveig Lena / Pfaller, Larissa (2016): Als wäre es völlig normal und einfach – Wirkmechanismen moralischer Botschaften deutscher Organspende-Kampagnen, In: 25. Jahrestagung der Deutschen Transplantationsgesellschaft, 05.-08.10.2016, Essen.
  • Pfaller, Larissa / Hansen, Solveig Lena / Schicktanz, Silke (2016): Ergebnisse einer quantitativen Umfrage unter Göttinger Studierenden vor und nach den Skandalen: Der Einfluss von Körperkonzepten und Einstellungen zum Hirntod auf die Spendebereitschaft, In: 25. Jahrestagung der Deutschen Transplantationsgesellschaft, 05.-08.10.2016, Essen.
  • Böhrer, Annerose / Pfaller, Larissa (2016): „Für mich ist es fast eine Grenzüberschreitung“. Zum Unbehagen mit der Organspende, In: Geschlossene Gesellschaften – 38. Kongress der Deutschen Gesellschaft für Soziologie, 26.-30.09.2016, Bamberg.
  • Hansen, Solveig Lena / Schicktanz, Silke / Pfaller, Larissa (2016): Zwischen Information und Befürwortung. Ethische Aspekte öffentlicher Gesundheitskommunikation am Beispiel der Organtransplantation (Posterpräsentation), In: Jahrestagung der Akademie für Ethik in der Medizin, 22.-24.09.2016, Bielefeld.
  • Böhrer, Annerose (2016): Materielle Kultur medizinischer Netzwerke am Beispiel Organspende, In: FIW Summer School 2016, Bridging the Gap: Soziologische Theorie und empirische Forschung, 06.-09.09.2016, Bonn.
  • Pfaller, Larissa / Hansen, Solveig Lena (2016): Warum das Nein zur Organspende so schwer fällt, In: Ja? Nein? Vielleicht? Diskurs und Kritik der Organspende. 18.-19.07.2016, Erlangen. Link Videoaufzeichnung
  • Böhrer, Annerose (2016): ,,Mein Ausweis, meine Entscheidung“? – Eine objektsoziologische Spurensuche im Organspendediskurs (Posterpräsentation), In: Ja? Nein? Vielleicht? Diskurs und Kritik der Organspende, 18.-19.07.2016, Erlangen.
  • Wunder, Angelika (2016): Wem möchte ich meine Organe spenden? (Posterpräsentation), In: Ja? Nein? Vielleicht? Diskurs und Kritik der Organspende, 18.-19.07.2016, Erlangen. Link Videoaufzeichnung
  • Hansen, Solveig, Lena / Schicktanz, Silke (2016): Face-to-face?! Zur moralischen Relevanz und sozialen Funktion visueller Botschaften in der Transplantationsmedizin, In: Nach der Hybridität. Medien und Politiken der Transplantationen, 23.-25.06.2016, Gießen.
  • Hansen, Solveig, Lena / Schicktanz, Silke (2016): No space for rejection?! The moral relevance of campaigns in the discourse of organ transplantation (Posterpräsentation), In: World Congress of Bioethics, 14.-17.06.2016, Edinburgh (Schottland).
  • Schicktanz, Silke / Hansen, Solveig Lena (2016): A critical reflection on moral claims and invocations of public campaigns for organ donation – Discrepancies, potential conflicts, and practical limitations, In: Workshop ELPAT-Working Group: “Public Issues”, 06.-08.05.2016, Granada (Spanien).
  • Hansen, Solveig Lena / Pfaller, Larissa (2016): Depicting Moral Messages – an Analysis of German Poster Campaigns on Organ Transplantation, In: 4th ELPAT Congress. Ethical, Legal and Psychological Aspects of Transplantation. Global Challenges, 22.-25.04.2016, Rom (Italien).
  • Pfaller, Larissa / Schicktanz, Silke / Hansen, Solveig Lena (2016): Increased Organ Donation Willingness after German Transplantation Scandals. The Influence of public Attitudes towards Brain-death and Concepts of the Body, In: 4th ELPAT Congress. Ethical, Legal and Psychological Aspects of Transplantation. Global Challenges, 22.-25.04.2016, Rom (Italien).
  • Pfaller, Larissa / Hansen, Solveig Lena (2016): Rejecting Organ Donation – A Typology of Reluctance (Posterpräsentation). In: 4th ELPAT Congress. Ethical, Legal and Psychological Aspects of Transplantation. Global Challenges, 22.-25.04.2016, Rom (Italien).
  • Schicktanz, Silke (2015): Moralische Appelle, Kampagnen und öffentliche Information zur Organspende: eine kritische Zwischenstandsanalyse, In: 27. Medizin-Theologie-Symposium der Evangelischen Akademie Tutzing: „…als wär`s ein Teil von mir…“ Zur Debatte um Hirntod, Organspende und Transplantation, 27.–29.11.2015, Rothenburg.
  • Hansen, Solveig Lena (2015): Pictures for Life. Analyzing the Moral Iconography of the German Organ Transplantation Foundation, In: International Workshop: ‘TO WHOM IT MAY CONCERN…’ Methodological and Ethical Perspectives of Visual Health Communication. Department of Medical Ethics and the History of Medicine, 07.10.2015, Göttingen.
  • Pfaller, Larissa / Hansen, Solveig Lena (2015): Projektvorstellung: „Ich möchte lieber nicht“, In: Die Kritik an der OrganspendeWorkshop, 31.03.2015, Erlangen.
  • Hansen, Solveig Lena / Pfaller, Larissa (2015): Soziologische und ethische Fragen an das Unbehagen mit der Organspende: Ein interdisziplinäres Projekt zur Praxis der Kritik, In: Organspende und Transmortalität: Die Perspektive der Medical Humanities, 20.03.2015, Aachen.
  • Schicktanz, Silke (2015): Finanzielle Anreize für die Organspende? Empirisch-ethische Überlegungen, Institut für Psychosomatik, Kolloquium, 12.01.2015, Charité Berlin.
  • Schicktanz, Silke (2014): Why giving organs? Empirical and ethical insights on altruism, incentives, and reciprocity, In: Bioethik-Kolloquium, 16.12.2014, Universitätsmedizin Innsbruck (Österrreich).

Downloads: Project Flyer (PDF)


Since 2012: ELPAT Working Group: "Public Issues of Organ Transplantation"

Head of the group:
Prof. Dr. Silke Schicktanz 
Prof. Gurch Randhawa, PhD


ELPAT is a European platform that brings continuity and progress in European research and dialogue on "Ethical, Legal and Psychosocial Aspects of Organ Transplantation”. Within ELPAT, there are seven working groups. Each working group addresses a specific topic in the field of ethical, legal and psychosocial aspects of organ transplantation 

One of the Working Groups, Public Issues, had been bringing together a range of experts and professionals from all around the world to share their experiences and insights into why and how public engagement was progressing. 

All members of the working group are members of the European Platform ELPAT 

Projekt website

Randhawa, Gurch; Schicktanz, Silke (Eds.): Public Engagement in Organ Donation and Transplantation, Pabst Publisher

Public campaigns in different European countries highlight an increasing awareness that public acceptance of organ donation is a crucial factor for the medical field of organ transplantation. However, addressing this complex matter requires a fresh perspective as to how governments truly engage with their public on issues which touch upon health care, morbidity, and mortality.
The book provides detailed recent analysis of cultural impacts and religious attitudes of communities, patients, and even professionals. Furthermore, various forms of public engagement, including dialogues, campaigns, and media are discussed from methodological as well as theoretical perspectives. 

Working group Public Issues ELPAT Meeting,  Juan les Pins, France, 2-day meeting, November 2013.


2009 – 2015: Survey: "Attitudes Towards Organ Donation. Influence of Gender and Study Background"

Carried out by:
Dr. Sabine Wöhlke, Dr. Julia Inthorn, Dr.Larissa Pfaller, Dr. Solveig Lena Hansen, Moritz Boos, M.A., Fabian Schmidt (med. Doktorand) 

Contact:
Prof. Dr. Silke Schicktanz sschick(at)gwdg.de

Public surveys are an important tool for assessing acceptance and (un)willingness to donate organs. Various opinion polls suggest, that a majority responds in favor of organ transplantation, but the number of individuals holding an organ donor card, has remained on a low level for years. Apart from the assumed laziness of the public to sign up for organ donor cards, other explanations for this attitude-action gap might be found in hidden cultural factors.

On the other side, since many years, health professionals and politicians discuss various options of financial incentives to increase the organ supply rather than relying on altruism in organ donation.

In ethical and economical debates about financial incentives it is generally assumed that incentives will work. Therefore the critical question rather seems, whether it is ethically and legally acceptable. However, there is a lacuna of empirical studies which have systematically investigated whether more citizens will donate encouraged by financial incentives. .

A quantitative survey has been conducted among students of medical science and economics at a mid-sized central German university to gain insights into the willingness to donate living and post mortem organs and attitudes towards different forms of commercialization (n=755).  The questionnaire consisted of 55 closed questions, amongst others the following: previous knowledge of organ transplantation, passive and active willingness to consent to postmortem and living donation, problems of allocation and commercialization and socio-demographic data.

Data have been analyzed in order to gain insights in the impact of university subject and sex on the willingness to donate and motivation through financial incentives.

Schicktanz, S; Pfaller, L; Hansen, SL; Boos, M (2017): A Comparison of Attitudes towards Brain Death and Body Concepts in Relation to Willingness or Reluctance to Donate: Results of a Students’ Survey before and after the German Transplantation Scandals.Journal of Public Health,25, 249–256.

Schicktanz, S; Pfaller, L; Hansen, SL (2016): Einstellungen zur Organspende –kulturell tief verwurzelt. Deutsches Ärzteblatt113, 37, A1586–1588

Sabine Wöhlke, Julia Inthorn, Silke Schicktanz (2015): The Role of Body Concepts for Donation Willingness. Insights from a Survey with German Medical and Economics Students. In: Ralf J. Jox, Galia Assadi, & Georg Marckmann (Hrsg.): Organ Donation in Times of Donor Shortage. Challenges and Solutions, Dordrecht Heidelberg u.a.: Springer; S. 27-51.

Julia Inthorn, Sabine Wöhlke, Fabian Schmidt, Silke Schicktanz (2014): Gender and professional Education Impact on Attitudes towards financial Incentives for Organ Donation: Results of a Survey among 755 Students of Medicine and Economics in Germany BMC Med Ethic, 15, 56, doi: 10.1186/1472-6939-15-56 (PDF)


2009 – 2010: Book: "Teaching Ethics in Organ Transplantation and Tissue Donation"

Editors: Silke Schicktanz, Claudia Wiesemann und Sabine Wöhlke in cooperation with Amnon Carmi UNESCO chair in Bioethics

Organ transplantation is a thrilling new option of modern surgery, giving hope to chronically ill patients, and, at the same time, stirring controversial ethical debates about human identity and the meaning of the human body. Being a transnational and global endeavor, organ transplantation raises universal ethical concerns but has to be adapted to culturally embedded believes. In this book, 30 international case studies collected from all over the world illustrate the range of global and local ethical, social, and cultural problems associated with this new form of treatment. Accompanied by a list of relevant movies, the collection provides a unique resource for ethics education in medicine, health care, philosophy, and religious studies. A systematic introduction into the field of transplantation ethics complements the teaching material. 

Publisher: Göttingen University Press, 2010 Softcover, 81 pp.: 15,00 € 
ISBN 978-3-941875-40-1 

An online-version is available at the link above.

You can find a review of the book here (German)

You can find further teaching materials of the UNESCO Chair of bioethics here


2008 – 2014: PhD Project: "Decision-Making Processes in the Context of Living Kidney Donation – Medical Ethics and Medical Anthropological Aspects"

Contact:
Dr. Sabine Wöhlke swoehlke(at)gwdg.de

Living donation is playing an increasingly important role in transplant medicine. It is usually advertised as an uncomplicated act of love and duty of care. The present study takes a precise look at the issue of living kidney donation in Germany. The empirical study opens the “black box” for family decision-making when it comes to donating live kidneys to science.

The focus is on the perspective of those affected. In view of the frequently observed shortage of organs, it is important to investigate the arguments, positions and uncertainties of those directly and indirectly affected by organ donation in more detail. The result of my work shows that the decision-making process is influenced by the reciprocal relationship of the donor-recipient-couple, since the kidney is given according to the rules of the “gift”. In addition, the decision is heavily influenced by self-determination in a relationship that includes role assignments and role expectations as well as gendered social and moral identities. In order to give an organ, body concepts are also essential, e.g. to ensure organ integration.

The motives of donors and recipients showed that family decisions are essentially reciprocity and that the entire family is involved in the process. The empirical evaluation of the dose makes an important contribution to the discussion on medical ethics, since reciprocity logics are activated in the family context for living donation. In addition, there are strong ambivalences and uncertainties among those affected because the symbolic value of a donation cannot be precisely determined. The consequences are subtle forms of gratitude and often feelings of guilt towards the donor.

Those affected have different ideas about the body, these have an impact on how and whether they can handle living donation. The fragmented body concept, which is shaped by biomedical ideas, is most widespread, but reference can be made to sub-types that are particularly powerful due to the processes of gender. Women with a reproductive understanding of the body often equate organ donation with birth and biological reproduction, men on the other hand with economic labor. It can be shown that a holistic understanding of the body can also be practically combined with organ donation /? Transplantation.

Not least due to the establishment in the Transplantation Act, the voluntary nature of the action is given high priority within the framework of the decision. But this is difficult to check. Donors as well as recipients refer to a relational autonomy concept, insofar as a decision was made in the context of the family. This family context also includes the respective roles of the individual in the family structure.

The results point to considerable differences between donors and recipients in terms of motivations and scope of action, so that a demand for a difference in perspective is an essential methodological result. The investigation therefore helps to take a closer look at the burdens on the donor-recipient relationship and provides concrete recommendations for action for all those involved in a live organ transplant.

"Donated organs? Ethical and cultural challenges in family living kidney donation"
Sabine Wöhlke (2015). Geschenkte Organe? Ethische und kulturelle Herausforderungen bei der familiären Lebendnierenspende, Campus, 300 Seiten. 
“So you can continue to live: The gift of kidney – Affected people tell their story"
Wöhlke, Sabine & Doyé, Lutz, (Hrsg.): Damit du weiterleben kannst: Die geschenkte Niere - Betroffene erzählen

A living kidney transplantation is actually a routine medical procedure. But at the same time, donor and recipient have to deal with a variety of issues, feelings and decisions. "Do I need to be forever grateful for my donation?" Such questions often change the whole structure of relationships.

In numerous field reports on those directly affected and their relatives, Sabine Wöhlke and Lutz Doyé show how complex the issue of live donation is. Besides the biographies of those directly involved in the book there are many scientific articles on the topic from the fields of medicine, medical ethics, theology, or the law.

The book means to encourage chronically ill patients to make the right decision for themselves and is an important guide for the duration of follow-up.

The book was only published in German.

Workshop: "Frauen geben, Männer nehmen?" Genderaspekte in der Organtransplantation – empirische, theoretische und normative Fragen, Erlangen, Januar 2014. (Download PDF)


1998 – 2001: PhD Project: "Medico-Ethical and Animal Ethical Aspects of Xenotransplantation –  The Ethical Assessment of the Current State of the Art"

Funded by the DFG-Graduiertenkolleg „Ethik in den Wissenschaften“ am Interfakultären Zentrum für Ethik in den Wissenschaften (IZEW), Universität Tübingen

Contact:
Prof. Dr. Silke Schicktanz sschick(at)gwdg.de

Many patients are waiting for a vital organ donation these days. In the future, animal organs, especially those from genetically modified pigs, are to remedy the shortage of human organs. The author weighs up the chances and risks of xenotransplantation for patients and the general public and asks whether it is ethically justified to genetically modify animals for this purpose, use them in experiments and kill them.

Awarded with the Young Academics Award of the Academy for Ethics in Medicine (Nachwuchspreis der Akademie für Ethik in der Medizin e.V.)

Schicktanz, Silke (2002). Organlieferant Tier? Medizin- und tierethische Probleme der Xenotransplantation. Frankfurt a.M.: Campus. (in German)

Summary:
The transplantation of animal tissue and organs (xenotransplantation) is one of the future options for transplantation medicine. However, this technology raises many unsolved practical and ethical problems.
This book integrates ethical reflections regarding humans and clinical trials as well as animal ethics. Concerning the medico-ethical problems, the focus is on clinical trials and the implications for patients, doctors, and the public. Therefore, the problems of weighing chances and risks will be specified and discussed. The book compares different European and U.S. American protocols and proposals how to regulate xenotransplantation and to guarantee safety under a medico-ethical perspective. Additionally, general parallels will be drawn between the debate of the handling of HIV in the 1980s and xenozoonoses today. This leads to the discussion of different scenarios for the future debate. Concerning animal ethics, various ethical questions will be discussed in detail: First, arising from the early stages of xenotransplantation, the ethical evaluation of killing an animal for the aim of getting transplants. But this perspective is still a reduction of the ethical problems since there are further aspects. Indeed the transgenic manipulation which is a primary condition for the use of pigs is an ethical problem itself. And thirdly, the increasing number of primate experiments in the field of xenotransplantation should be another important issue of ethical reflection.
Methodologically, ethical reflection starts on a general level, looking at how to balance broader medico- and animal-ethical questions. It then continues on a more context sensitive, practical level, which also includes the actual state of the art of research, alternatives, and socio-cultural and political arguments. Overall, the final ethical assessment comes to a sceptical position regarding whether xenotransplantation really is an ethical option to solve the problem of a shortage in sufficient organs.